RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXX		CASE: PD-2021-00082 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20040430

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Aviation Supply Clerk, medically separated for “degenerative disk disease, L4-5, L5-S1” with a disability rating of 20%.

CI CONTENTION: Review all conditions as well as additional conditions not identified by the Medical Evaluation Board (MEB) and/or Physical Evaluation Board (PEB).

SCOPE OF REVIEW: The panel’s scope of review is defined in DoDI 6040.44. It is limited to review of disability ratings assigned to those conditions determined by the PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the MEB, but determined by the PEB to be not unfitting or non-compensable. Any conditions outside the panel’s defined scope of review, and any contention not requested in this application, may remain eligible for future consideration by the Board for Correction of Military Records. The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate. The panel gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of disability at the time of separation.

RATING COMPARISON:

SERVICE PEB - 20040303	VARD - 20040628	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Degenerative Disk Disease (DDD) L4-S1	5242	20%	Herniated Nucleus Pulposus (HNP), Lumbar Spine	5243	20%	20040401	
Left Sided HNP	Cat II	Radiculopathy, Left Lower Leg	8520	20%		
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 80%	

ANALYSIS SUMMARY:

DDD. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s back condition began in June 2002 after running. The 14 November 2003 MEB NARSUM examination, 6 months prior to separation, noted complaints of daily back and left leg pain, with shooting pain into the legs. Physical examination showed normal lower extremity motor strength with some leg calf muscle fatigue after 10 heel lifts. Sensation was intact; thoracolumbar range of motion (ROM) was not recorded.

During the 10 December 2003 MEB examination (recorded on DD Forms 2807-1 and 2808), the CI reported a 2-year history of back pain that radiated down the left leg with numbness and tingling in the foot. Her pain was refractory to epidural steroid therapy. Physical findings revealed normal spine and lower extremities.

Controlled by: DAF Controlled by: SAF/MRBD
CUI Categories: SP-MIL/SP-PRVCY Limited Dissemination Control: N/A POC: SAF.MRBD.Workflow@us.af.mil

At the 1 April 2004 VA Compensation and Pension (C&P) examination, 1 month before separation, the CI reported low back and left lower extremity pain associated with numbness, tingling, and burning sensations. Physical examination showed normal gait and extremities. Thoracolumbar flexion was to 55 degrees (normal 90), with pain, and combined ROM was 175 degrees (normal 240). Lower extremity motor strength was normal, with cranial nerves intact, and no muscle atrophy. Deep tendon reflexes were normal throughout, but there was decreased sensation in the “lateral aspect of the left calf with extension to the tip of the toes.” The examiner diagnosed “left lower extremity radiculopathy, secondary to lumbar spine condition.”

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the low back condition 20%, coded 5242 (degenerative arthritis of the spine), but did not cite a rationale for the rating. The PEB listed the left herniated nucleus pulposus as a related Category II condition (contributes to the primary unfitting condition but not separately unfitting). Panel members concluded the Category II diagnosis was not a separate condition which could be reasonably justified as separately unfitting; nor would a separate rating be achievable without violation of VASRD §4.14. The VA also rated the low back condition 20%, coded 5243 (intervertebral disk syndrome), based on the C&P examination, citing painful and limited motion of the thoracolumbar spine. Panel members agreed that a 20% rating, but no higher, was justified for limitation of flexion (greater than 30 degrees but not greater than 60 degrees), as reported on the VA examination. There was no associated radiculopathy for separate peripheral nerve rating. While the CI may have experienced radiating pain from the back condition, this is subsumed under the general spine rating criteria, which specifically states “with or without symptoms such as pain (whether or not it radiates).” There was no objective evidence of a radiculopathy with functional impairment (such as weakness) that directly impacted fitness for duty. The panel therefore concluded that an additional disability rating was not justified on this basis. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the low back condition.

BOARD FINDINGS: In the matter of the degenerative disk disease and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication. There are no other conditions within the panel’s scope of review for consideration. Therefore, the panel recommends no modification or re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20210601, w/atchs Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Record

9/6/2022

2	PD-2021-00082
CUI//SP-PRVCY

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THE ASSISTANT SECRETARY OF THE NAVY
(MANPOWER AND RESERVE AFFAIRS) I 000 NAVY PENTAGON
WASHINGTON, D. C 20350-1000

6040
Memo 00/01 31 Oct 22

MEMORANDUM FOR DEPUTY COMMANDANT, MANPOWER AND RESERVE AFFAIRS
Subj:	 PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATION Ref:	(a) DODI 6040.44
(b) PDBR ltr dtd 6 Sep 22 ICO

1.	Pursuant to reference (b), the recommendation of the Physical Disability Board of Review set forth in reference (b) is approved. The official record of the following individual is to be corrected as follows:

XXXXXXXXXX former USMC: No Change.

2.	Please take action to implement these decisions and provide notification to the above individuals once those actions are complete.